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HOUSE CALL WITH DR. SANJAY GUPTA

A look at Weight Loss and HIV/AIDS

Aired February 12, 2005 - 08:30   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


TONY HARRIS, CNN ANCHOR: Now in the news, North Korea's state run media are calling for unity in the latest confrontation with the latest confrontation with the U.S. over nuclear weapons. Washington has rejected North Korea's call for one on one talks and says Pyongyang should return to six-nation negotiations. But North Korea's top U.N. diplomat calls six-party talks an old story.
Powerful winds and driving rain led off the weekend in Southern California, bringing floods and hundreds of traffic accidents and crashes. The storm is blamed for at least three deaths. More than three inches of rain fell in some areas. And winds gusted at 69 miles an hour.

Doctors at hospitals in New York are alerted to a new strain of AIDS resistant to anti-viral drugs and progressing to full-blown AIDS within months. The strain has been diagnosed in one man who often uses methamphetamines, but no connection between the disease and the drug has been confirmed.

I'm Tony Harris. HOUSECALL begins right now.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: A little pill with a powerful punch gives men's sex lives as boost. Low fat to low carb, meat becomes a diet food.

CHRISTOPHER REEVE, ACTOR: It's a miracle. It's something that has unlimited potential for curing people.

UNIDENTIFIED FEMALE: Fighting over cells. The top 25 stories in the past 25 years, breakthroughs in health that changed our lives.

(END VIDEO CLIP)

SANJAY GUPTA, HOST: Welcome to HOUSECALL. I'm Dr. Sanjay Gupta.

And this morning, we're bringing you the top 25 health stories that changed our lives in the past 25 years. Let's start with obesity. In a nation of super size fries, there are now super size people. One in three American adults is obese. And with that comes a whole set of health problems.

Holly Firfir weighs in.

(BEGIN VIDEOTAPE)

HOLLY FIRFIR, CNN CORRESPONDENT (voice-over): Big, bigger, deadly. This year complications of obesity will kill an estimated 365,000 Americans. This is not just losing 10 pounds you gained over the holidays. We're talking about an obesity epidemic, 59 million people whose lives are at risk according for the Centers for Disease Control and Prevention because they need to lose weight.

WILLIAM DIETZ, DR., CDC: Obesity is the epidemic of the century. Over 30 percent of adults in this country are obese, defined as body mass index greater than or equal to 30. Our concern about this problem is that obesity is the major cause of heart disease, type two diabetes and cancer.

FIRFIR: It's not just a matter of too many adults visiting the fast food drive-throughs. Since 1980, according to the government, obesity rates have doubled among children and tripled among adolescents.

The problem, high fat, high calorie foods and physical inactivity, by-products of our high tech couch potato lifestyles. Even though Americans are so obsessed with dieting that it's become a $40 billion a year industry, we are fatter than ever.

ADELE MILLER, WEIGHT WATCHERS MEMBER: Just sort of crept up on me. I gained like maybe one or two pound as year. Over time, that turned into like 30 pounds. And that was very -- that's a lot of weight for me. I could feel it. I started snoring. I started having heartburn. I started having pains in my knees.

UNIDENTIFIED FEMALE: My target weight is -- let's just say I have 112 pounds to lose to get there.

FIRFIR: It's not just a problem in this country. According to estimates from the World Health Organization, 22 million of the world's children under the age of 5 are overweight. The number of overweight adults, according to these estimates, has reached 1 billion worldwide. Nearly one-third are classified as obese.

DIETZ: If we don't successfully prevent obesity, we're going to be paying the costs of the complications of this disease well into the next three or four decades. And those costs are going to be the costs of heart disease, diabetes, and cancer, all of which are linked to obesity.

(END VIDEOTAPE)

GUPTA: So you've gained weight. Well, what are your options? Diet and exercise, of course, are what the doctor ordered. But many people turn to the newest diet trends looking for a quick fix. And that brings us to the low carb explosion. And back again to Holly Firfir.

(BEGIN VIDEOTAPE)

FIRFIR (voice-over): Low carb, it's all the craze now. UNIDENTIFIED MALE: They'll help you satisfy the low carb goals.

UNIDENTIFIED FEMALE: TGI Friday's new Atkins approved menu.

FIRFIR: Even the beer ads have gone from less filling to...

UNIDENTIFIED MALE: This beer has one-third less carbs than Coors Lite.

FIRFIR: And magazines advertising low carb rum, which never had any carbs in the first place. Burger chains are also helping people lose carbs, so they don't lose customers. Burger King and In and Out Burger now sell bunless burgers with lettuce replacing the bread.

It appears that 30 years after Dr. Robert Atkins published his first diet book, his diet revolution has really taken off. And now, more and more products bear his name.

But there's more to low carb than just Atkins. Demand is so high now that entire stores are dedicated to low carb products. There's low carb pancake mix and syrup, low carb tortilla chips, even low carb ice cream and candy.

So is this the panacea? Is this how two-thirds of Americans who are overweight or obese will lose weight? Or is this just the newest equivalent of the low-fat snack well craze of the early '90s? Some health experts might say it's the latter because many dieters seem to interpret low carb diet to mean eat all the red meat you want and don't worry about the calories, an approach Atkins and other low carb diets do not support.

(END VIDEOTAPE

GUPTA: We're highlighting some of the top 25 health stories from the past 25 years. So where do you think the low carb craze ranks? Check out CNN on Sunday night at 8:00 p.m. You'll find out where your favorite story falls in our top 25.

Twenty-five years ago we didn't even know that it existed. Coming up on HOUSECALL, four letters that changed our lives.

(BEGIN VIDEO CLIP)

UNIDENTIFIED MALE: Every time I went out of my apartment, I would see people dying.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: A deadly disease we're still fighting today.

And 20 years later, a tiny blue pill changes the lives of men around the world. Which brings us to our quiz, when Googled, which drug has the most hits? Tylenol, Viagra or Aspirin? The answer when we come back.

(COMMERCIAL BREAK)

UNIDENTIFIED FEMALE: Checking the daily dose quiz, we asked when Googled, which drug has the most hits? Tylenol, Viagra or aspirin? The answer, Viagra.

Google lists over 41 million pages using the word Viagra. Tylenol comes in second with 5.3 million.

GUPTA: And we'll get to Viagra in a moment. I promise.

First though, it was thought of as a gay white man's disease in the early '80s, but AIDS has become a global epidemic affecting millions. An estimated 14,000 people every day become HIV positive.

So more than 20 years later where do we stand?

(BEGIN VIDEOTAPE)

GUPTA (voice-over): Dr. Bruce Rashbaum has been on the frontlines of HIV for about 20 years, as both a doctor and a patient.

BRUCE RASHBAUM, DR., INTERNIST: In 1997, I took 20 pills. Other patients certainly could have taken more than that. Some people probably took 30 pills.

GUPTA: That was every day. Now HIV treatment has been so well refined, he and many patients like him are down to about three or four pill as day. But the fact that people like Rashbaum, who were infected in the early days, are even alive is quite significant.

The year was 1981. And here in the U.S., the first cases of a yet unnamed mystery disease began appearing in gay men.

ANTHONY FAUCI, DR., NATL. INSTITUTES OF HEALTH: I didn't really anticipate that we would have one of the most devastating, if not the most devastating global pandemic in history.

GUPTA: 1982, the term Acquired Immune Deficiency Syndrome or AIDS is first used. And within a year, researchers had determined it was the HIV virus that was destroying the patient's immune system and killing them.

CLEVE JONES, FOUNDER, AIDS QUILT: Every time I went out of my apartment, I would see people dying, people my age walking around on canes with no hair.

GUPTA: Then in 1996, things changed. A class of drugs called protease inhibitors were approved by the FDA. Doctors began to combine them with other HIV medicine into an AIDS drug cocktail. And HIV was no longer considered a death sentence.

FAUCI: Certainly is not a cure, but it was a dramatic turnaround.

GUPTA: But the drugs are expensive. still costing as much as $10,000 a year. Financially, out of reach for many of the estimated 40 million people worldwide who now have HIV-AIDS.

PETER POT, DR., UNAIDS: Without expanding prevention, and treatment efforts in the developing world over the next decades, tens of millions of people are going to die.

GUPTA: Some experts say a vaccine is the only hope for stopping the disease. But so far, efforts to develop a vaccine haven't panned out.

FAUCI: If you don't have anybody recovering completely from HIV, then you don't have any blueprint for where you want to go with your vaccine.

GUPTA: Without a vaccine, the spread of HIV is best reduced by treating those who have the disease.

FAUCI: I think we will for a very long time have a world with HIV, but I think a world in which the epidemic is going in the opposite direction is within our grasp.

(END VIDEOTAPE)

GUPTA: AIDS and HIV are increasing among some older Americans as well. Experts say part of the reason is medicines to treat impotence, which allows seniors to stay sexually active longer.

Now the first of these drugs was Viagra. That's been called the miracle drug. That over the years changed the sex lives of millions. Let's take a look.

(BEGIN VIDEOTAPE)

UNIDENTIFIED MALE (voice-over): It's what millions of men have been dreaming of, a new pill to treat impotence. It's called Viagra.

JOE FECZKO, DR., PFIZER, INC.: Viagra works naturally with sexual stimulation. It is not an aphrodisiac. As an oral tablet, it is simple, straightforward to use and non-invasive, helping to maintain spontaneity and intimacy.

ELIZABETH COHEN, CNN CORRESPONDENT: One month after Viagra hit the market, doctors are having to deal with Viagra failure.

STEVE MORGANSTEIN, DR., UROLOGIST: When your hopes have been so high, and when you get a patient and it doesn't work, they're depressed. They feel devastated.

UNIDENTIFIED MALE: Viagra has taken the country by storm and revolutionized the treatment of impotence. But even miracles can have drawbacks. It turns out Viagra can be deadly when taken with certain medications. Of primary concern -- nitroglycerin.

COHEN: So far about 150,000 women have been prescribed Viagra.

JOANNE, TAKING VIAGRA: There are women who have needs that must be addressed as equally as their male counterparts. COHEN: Alex owes her life to Viagra her parents say. No, her father didn't take it. Her mother did after conventional fertility treatments failed.

MELISSA WAGNER, VIAGRA MOM: He called and he said, "Melissa, are you ready to be a mother?"

COHEN: And now they await their second Viagra baby.

UNIDENTIFIED MALE: Viagra, the first pill for impotence, is pricing medical assistance for sex out of the market for a growing number of health insurers.

SUSAN PISANO, AMERICAN ASSOC. OF HEALTH PLANS: Some plans have determined that if they provide Viagra as a basic benefit, they will need to raise premiums for all patients. And they've asked themselves is that the right thing do.

UNIDENTIFIED FEMALE: The break through pill to treat mail impotence has become in five years one of the best known brand names in the world.

TONY BUTLER, PHARMACEUTICAL ANALYST: The number of people approaching the age of 50 is increasing in every year.

UNIDENTIFIED FEMALE: That sets the stage for a little known rival, expected to soon win FDA approval named Levitra.

(END VIDEOTAPE)

GUPTA: And today, of course, Viagra has competition from two other drugs with other drugs still in clinical trials.

We're counting down medicine's biggest stories when HOUSECALL returns.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: A medical breakthrough has scientists, politicians and actors pitted against each other. And later...

UNIDENTIFIED FEMALE: When I turn the unit on, what's going to happen 2000 yellow tiny lights will start to flicker.

UNIDENTIFIED FEMALE: The bright lights of Hollywood, how stars struggle for the perfect face.

But first, this week's medical headlines in the pulse.

(END VIDEO CLIP)

(BEGIN VIDEOTAPE)

CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Experts say that breastfeeding is the best thing for your baby, but doing it correctly is key. This week, the American Academy of Pediatrics released updated breastfeeding guidelines, affirming that mothers should feed babies only breast milk for a period of six months.

Another recommendation, see the doctor twice within the first three weeks of breastfeeding.

And DHEA, an over-the-counter hormonal supplement believed to slow aging, could prove useful in treating mild to moderate depression. The National Institute of Mental Health study found that DHEA may be an effective alternative for patients who don't respond well to antidepressants. The small study found that nearly twice as many patient whose took DHEA showed a marked decrease in depression compared with those who took a placebo. But researchers warn the long-term effects of taking DHEA need to be investigated further.

Christy Feig, CNN.

(END VIDEOTAPE)

(COMMERCIAL BREAK)

GUPTA: Make sure to tune into CNN's "Top 25" special on Sunday night to find out where these stories rank. In the late '90s researchers discovered tiny cells with enormous possibilities - embryonic stem cells. They offer hope to millions, but are still caught up in a web of controversy.

Elizabeth Cohen filed this report just months after we first heard the words "stem cells".

(BEGIN VIDEOTAPE)

ELIZABETH COHEN, CNN CORRESPONDENT (voice-over): They keep stem cells under lock and key. Stem cells are so valuable because one day, doctors think they will be used to treat all sorts of ailments. Everything from heart disease, to skin burns, to Parkinson's disease.

JOSEPH ITSKOVITZ, DR., STEM CELL RESEARCHER: We're talking about new technologies that are going to revolutionize medicine.

COHEN: So what exactly are stem cells? They're blank cells that potentially can be turned into virtually any tissue in the human body, basically creating a supply of spare body tissues.

JOHN GEARHART, DR., JOHN HOPKINS UNIV.: So imagine you can grow up millions of cells in a dish, and then giving it a signal of some sort, you can then convert those cells into a million neurons of some kind, or a million cardiac muscle cells.

COHEN: And what would doctors do with the supply of cardiac muscle cells? When someone has a heart attack, these cells are damaged. A dose of new cells made in the lab could heal the damage. So when will all this happen?

GEARHART: I think with certain cell types, we could certainly consider a five to seven year period as being within reach.

COHEN: Only three universities have managed to manufacture stem cells in the lab. To do so, they had to start with a human embryo or fetus. Dr. John Gearhart used aborted fetuses. Dr. Joseph Itskovitz in Israel used fertilized eggs that were in a lab and no longer needed by couples undergoing fertility treatments.

Some Catholic leaders object to this type of research. But this week, the National Institutes of Health said that they'd start funding it. And doctors say that this will speed up progress on stem cell research tremendously.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: Well since the story aired, the U.S. government approved federal funding, but only for 64 stem cell lines, which existed before August of 2001. However to date, less than a quarter of those original lines seem to work. And new studies show that those same stem cell lines are contaminated and may not be able to be used for human therapies.

So the controversy rages on. And of course, we'll keep following the story.

From new cells to new noses and chins and the list goes on. Changing bodies when HOUSECALL returns. Don't change the channel.

(BEGIN VIDEO CLIP)

UNIDENTIFIED FEMALE: Everybody is getting on the bandwagon. All ages, all income levels, all ethnicities.

(END VIDEO CLIP)

UNIDENTIFIED FEMALE: Striving for perfection or at least fewer wrinkles. Stay tuned.

(COMMERCIAL BREAK)

GUPTA: Welcome back to HOUSECALL. Ever wonder what your favorite celebrity does to keep looking Oscar worthy? Well our bod squad follows the latest crazes.

(BEGIN VIDEOTAPE)

COHEN: For celebrities, the sky's the limit when it comes to their faces.

KERRY DIAMOND, HARPER'S BAZAAR BEAUTY EDITOR: It's all about super high tech creams. It's about high tech treatments that you can get at the dermatologist. Because when you're a celebrity, your face is everything.

COHEN: And that's why celebs dish out $387 for a one-hour Tracey Martin facial. Her claim?

UNIDENTIFIED FEMALE: Very mild electrical currents. And it actually helps to reduce puffiness and to help redefine and contour the jaw line.

COHEN: And how about this?

FRANCESCA FUSCO, DR., DERMATOLOGIST: When I turn this unit on, what's going to happen is 2,000 yellow tiny lights will start to flicker. And it will last for about 30 seconds.

COHEN: And those 30 seconds cost $150. So are flashing lights and electrical currents, not to mention $1200 skin creams, really better than the stuff the rest of us buy at the drugstore?

RON SHELTON, DR., AMERICAN ACADEMY OF DERMATOLOGY: If you use a good old facial moisturizer in the average drugstores, I think they will be fine.

COHEN: These products, while maybe not star quality, are good enough for the rest of us.

Elizabeth Cohen, CNN, Atlanta.

(END VIDEOTAPE)

GUPTA: And we're taking a look at some of the unforgettable medical stories over the last 25 years. Now it used to be only celebrities or the very rich could afford to have plastic surgery. Not anymore. As Elizabeth Cohen reports, millions of Americans are willing and able to go under the knife to change the way they look and the way they feel.

(BEGIN VIDEOTAPE)

COHEN (voice-over): In a world of extreme makeovers, and swans...

UNIDENTIFIED MALE: A team of plastic surgeons will turn these 16 average women into drop dead beauties.

COHEN: Plastic surgery experts say these reality shows telling people they can change anything they don't like about their appearance are fueling a boom in cosmetic surgery.

More cosmetic procedures are performed in the U.S. than in any other country, according to the International Society of Aesthetic Plastic Surgery. In 2003, that number topped 8.3 million. That's a 20 percent increase from 2002 and a 293 percent increase in the total number of cosmetic procedures since 1997.

It all started with images like this. And this. Breast augmentation, liposuction and tummy tucks to suck the fat, facelifts, nose reshaping, and eyelid surgery are the most popular surgical procedures. And it seems like everyone is doing it.

LYNNE LUCIANO, SOCIAL HISTORIAN: Everybody is getting on the bandwagon. All ages, all income levels, all ethnicities.

COHEN: While women represent the majority, the number of men is on the rise.

MILES GRAVIER, DR., PLASTIC SURGEON: It's not a stigma anymore to go in, even for a man to have some type of cosmetic surgery procedure.

COHEN: Safety issues plagued the industry in the 1990s.

(on camera): Fear over leaking breast implants led to a ban on silicone. Saline's is an alternative and newer materials such as cohesive gel, which some say are safer, are under consideration by the U.S. Food and Drug Administration. They could get approval later this year.

(voice-over): There were even deaths from liposuction blamed on the removal of too much fat and centers ill-equipped to handle what went wrong during surgery. But with new technology and some safer procedures, that's all changing.

Less invasive surgeries are an option, promising a shorter recovery getting patients home and even back to work within days.

BRIAN KINNEY, DR., PLASTIC SURGEON: The emphasis is on minor procedures, smaller procedures, quicker return to work.

COHEN: And there's a move towards simplicity. Over 6 million non-surgical cosmetic procedures were performed in 2003. Plastic surgeons say patients are now opting for classical features.

KINNEY: People coming in and say I don't want to be extreme and I don't want to be made over. I want to be subtle. I want to be natural.

COHEN: Perhaps cosmetic procedures are creating a new natural.

(END VIDEOTAPE)

GUPTA: Interesting stuff. So where do you think cosmetic surgery ranks on our list? Find out what made it number one as well on Sunday night at 8:00 p.m. I'll be counting down the top 25 medical stories of the last 25 years.

Also, make sure to tune in next weekend for another HOUSECALL, an important one. We're going to be finding out how safe the drugs in your medicine cabinet are from Vioxx to Celebrex and Aleve. What can you take for your pain nowadays? That's next week on HOUSECALL, 8:30 Eastern.

Thanks for watching. I'm Dr. Sanjay Gupta. Stay tuned now for more news on CNN.

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